Infections from Clostridium difficile, a bacteria that causes diarrhea and other health issues, are a patient safety concern in all types of medical facilities, not just hospitals as traditionally thought, according to a new Vital Signs report from the US Centers for Disease Control and Prevention (CDC). C difficile infection rates and deaths have climbed to historic highs.

“C difficile harms patients just about everywhere medical care is given,” said CDC Director Thomas R. Frieden, MD, MPH. “Illness and death linked to this deadly disease do not have to happen. Patient lives can be saved when healthcare providers follow the 6 steps to prevention, which include key infection control and smart antibiotic prescribing recommendations.” C difficile is linked to about 14,000 US deaths every year. Those most at risk are people who take antibiotics and also receive care in any medical setting. Almost half of infections occur in people younger than age 65 years, but more than 90% of deaths occur in people age 65 years and older. Patients get C difficile infections most often within a few months of taking antibiotics and also receiving medical care. Antibiotics are lifesaving medicines that stop infections, but they also destroy the body’s good bacteria for several months. During this time, patients can get sick from C difficile picked up from contaminated surfaces or spread from a healthcare provider’s hands. Identifying C difficile infection early and stopping its spread to other people can save lives.

The 6 steps to prevention are: (1) Pre­scribe and use antibiotics carefully. About 50% of all antibiotics given are not needed, unnecessarily raising the risk of C difficile infections. (2) Test for C difficile when patients have diarrhea while on antibiotics or within several months of taking them. (3) Isolate pa­tients with C difficile immediately. (4) Wear gloves and gowns when treating pa­tients with C difficile, even during short visits. Hand sanitizer does not kill C difficile, and hand washing may not be sufficient. (5) Clean room surfaces with bleach or another EPA-approved, spore-killing disinfectant after a patient with C difficile has been treated there. (6) When a patient transfers, notify the new facility if the patient has a C difficile infection.